Hypertrophic pulmonary osteoarthropathy: Difference between revisions
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==Overview== | ==Overview== | ||
'''Hypertrophic pulmonary osteoarthropathy'''<ref name="pmid17006703">{{cite journal |author=Armstrong DJ, McCausland EM, Wright GD |title=Hypertrophic pulmonary osteoarthropathy (HPOA) (Pierre Marie-Bamberger syndrome): two cases presenting as acute inflammatory arthritis. Description and review of the literature |journal=Rheumatol. Int. |volume=27 |issue=4 |pages=399–402 |year=2007 |month=February |pmid=17006703 |doi=10.1007/s00296-006-0224-2 |url=http://dx.doi.org/10.1007/s00296-006-0224-2}}</ref> is a medical condition combining [[clubbing]] and [[synovitis]]. This is the combination of clubbing and thickening of [[periosteum]] (connective tissue lining of the bones) and [[synovium]] (lining of joints), and is often initially diagnosed as [[arthritis]]. | '''Hypertrophic pulmonary osteoarthropathy'''<ref name="pmid17006703">{{cite journal |author=Armstrong DJ, McCausland EM, Wright GD |title=Hypertrophic pulmonary osteoarthropathy (HPOA) (Pierre Marie-Bamberger syndrome): two cases presenting as acute inflammatory arthritis. Description and review of the literature |journal=Rheumatol. Int. |volume=27 |issue=4 |pages=399–402 |year=2007 |month=February |pmid=17006703 |doi=10.1007/s00296-006-0224-2 |url=http://dx.doi.org/10.1007/s00296-006-0224-2}}</ref> is a medical condition combining [[clubbing]] and [[synovitis]]. This is the combination of clubbing and thickening of the [[periosteum]] (connective tissue lining of the bones) and [[synovium]] (lining of joints), and is often initially diagnosed as [[arthritis]]. | ||
It is also known as "osteoarthropathia hypertrophicans".<ref name="pmid9885895">{{cite journal |author=Deller A, Heuer B, Wiedeck H |title=Is myositis ossificans following ARDS a complication of prone-dependency or is it osteoarthropathia hypertrophicans (Bamberger-Marie syndrome)? |journal=Intensive Care Med |volume=24 |issue=12 |pages=1345–6 |year=1998 |month=December |pmid=9885895 |doi= |url=http://link.springer-ny.com/link/service/journals/00134/bibs/8024012/80241345.htm}}</ref> | It is also known as "osteoarthropathia hypertrophicans".<ref name="pmid9885895">{{cite journal |author=Deller A, Heuer B, Wiedeck H |title=Is myositis ossificans following ARDS a complication of prone-dependency or is it osteoarthropathia hypertrophicans (Bamberger-Marie syndrome)? |journal=Intensive Care Med |volume=24 |issue=12 |pages=1345–6 |year=1998 |month=December |pmid=9885895 |doi= |url=http://link.springer-ny.com/link/service/journals/00134/bibs/8024012/80241345.htm}}</ref> | ||
==Historical Perspective== | ==Historical Perspective== | ||
It is named for Eugen von Bamberger and [[Pierre Marie]].<ref>{{WhoNamedIt|synd|1756}}</ref><ref>E. von Bamberger. Veränderungen der Röhrenknochen bei Bronchiektasie. Wiener klinische Wochenschrift, 1889, 2: 226.</ref><ref>P. Marie. De l’osteo-arthropathie hypertrophiante pneumique.Rév Med, Paris, 1890, 10: 1-36.</ref> | It is named for Eugen von Bamberger and [[Pierre Marie]].<ref>{{WhoNamedIt|synd|1756}}</ref><ref>E. von Bamberger. Veränderungen der Röhrenknochen bei Bronchiektasie. Wiener klinische Wochenschrift, 1889, 2: 226.</ref><ref>P. Marie. De l’osteo-arthropathie hypertrophiante pneumique.Rév Med, Paris, 1890, 10: 1-36.</ref> | ||
==Pathophysiology== | |||
===Associated Conditions=== | |||
*[[Lung cancer]] | |||
==Causes== | |||
===Causes in Alphabetical Order=== | |||
*[[Mesothelioma]] | |||
*[[Pleural fibroma]] | |||
==Diagnosis== | |||
===Symptoms=== | |||
Some of the symptoms include: | |||
*[[Arthropathy]] | |||
*[[Digital clubbing]] | |||
*[[Gynaecomastia]] | |||
===X-ray === | |||
* Pachydermoperiostosis | |||
** The predominant radiographic periostitis, which is depicted as symmetric osseous thickening. | |||
** Periostitis mostly affects the tubular bones of the limbs, especially the radius, ulna, tibia, and fibula, although the pelvis, carpus, tarsus, metacarpals, metatarsals, and phalanges can be involved. | |||
** Periosteal proliferation is usually shaggy and associated with irregular excrescences and diaphyseal expansion. | |||
* Secondary hypertrophic osteoarthropathy | |||
** Usually involves diaphyseal and metaphyseal periostitis. | |||
* Periosteal proliferation is usually single or laminated and regular or irregular. | |||
* Laminated periostitis may have an onionskin appearance. | |||
* Periarticular soft tissue swelling, clubbing, and clinical and radiologic features of an underlying primary lesion are often depicted. | |||
* Digital clubbing associated with soft tissue swelling may be depicted on plain radiographs. | |||
'''Hypertrophic osteoarthropathy in a patient with thymic carcinoma''' | |||
<gallery> | |||
Image: | |||
Hypertrophic-osteoarthropathy-001.jpg | |||
Image:Hypertrophic-osteoarthropathy-002.jpg | |||
</gallery> | |||
===Other Imaging Findings=== | |||
====Nuclear medicine==== | |||
* Bone scan with technetium Tc 99m–labeled diphosphonate shows changes of HOA early and with sensitivity greater than that of other methods. | |||
* Isotope uptake is symmetrically increased in the tubular bones along the cortical margins of the diaphysis and metaphysis. | |||
* Uptake may be irregular, or it may create a double-stripe or parallel-track sign. | |||
* Periarticular radionuclide uptake may be increased as a result of associated synovitis. | |||
==See also== | ==See also== | ||
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{{reflist|2}} | {{reflist|2}} | ||
[[Category:Autoimmune diseases]] | |||
[[ja:肥大性肺性骨関節症]] | [[ja:肥大性肺性骨関節症]] | ||
Latest revision as of 18:00, 5 August 2012
| Hypertrophic pulmonary osteoarthropathy | |
| ICD-10 | M89.4 |
|---|---|
| ICD-9 | 731.2 |
| DiseasesDB | 6388 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: Pierre Marie-Bamberger disease; Bamberger-Marie disease; osteoarthropathia hypertrophicans; pulmonary hypertrophic osteodystrophy; pulmonary osteoarthropathy; hypertrophic pulmonary osteo-arthropathy
Overview
Hypertrophic pulmonary osteoarthropathy[1] is a medical condition combining clubbing and synovitis. This is the combination of clubbing and thickening of the periosteum (connective tissue lining of the bones) and synovium (lining of joints), and is often initially diagnosed as arthritis. It is also known as "osteoarthropathia hypertrophicans".[2]
Historical Perspective
It is named for Eugen von Bamberger and Pierre Marie.[3][4][5]
Pathophysiology
Associated Conditions
Causes
Causes in Alphabetical Order
Diagnosis
Symptoms
Some of the symptoms include:
X-ray
- Pachydermoperiostosis
- The predominant radiographic periostitis, which is depicted as symmetric osseous thickening.
- Periostitis mostly affects the tubular bones of the limbs, especially the radius, ulna, tibia, and fibula, although the pelvis, carpus, tarsus, metacarpals, metatarsals, and phalanges can be involved.
- Periosteal proliferation is usually shaggy and associated with irregular excrescences and diaphyseal expansion.
- Secondary hypertrophic osteoarthropathy
- Usually involves diaphyseal and metaphyseal periostitis.
- Periosteal proliferation is usually single or laminated and regular or irregular.
- Laminated periostitis may have an onionskin appearance.
- Periarticular soft tissue swelling, clubbing, and clinical and radiologic features of an underlying primary lesion are often depicted.
- Digital clubbing associated with soft tissue swelling may be depicted on plain radiographs.
Hypertrophic osteoarthropathy in a patient with thymic carcinoma
Other Imaging Findings
Nuclear medicine
- Bone scan with technetium Tc 99m–labeled diphosphonate shows changes of HOA early and with sensitivity greater than that of other methods.
- Isotope uptake is symmetrically increased in the tubular bones along the cortical margins of the diaphysis and metaphysis.
- Uptake may be irregular, or it may create a double-stripe or parallel-track sign.
- Periarticular radionuclide uptake may be increased as a result of associated synovitis.
See also
References
- ↑ Armstrong DJ, McCausland EM, Wright GD (2007). "Hypertrophic pulmonary osteoarthropathy (HPOA) (Pierre Marie-Bamberger syndrome): two cases presenting as acute inflammatory arthritis. Description and review of the literature". Rheumatol. Int. 27 (4): 399–402. doi:10.1007/s00296-006-0224-2. PMID 17006703. Unknown parameter
|month=ignored (help) - ↑ Deller A, Heuer B, Wiedeck H (1998). "Is myositis ossificans following ARDS a complication of prone-dependency or is it osteoarthropathia hypertrophicans (Bamberger-Marie syndrome)?". Intensive Care Med. 24 (12): 1345–6. PMID 9885895. Unknown parameter
|month=ignored (help) - ↑ Template:WhoNamedIt
- ↑ E. von Bamberger. Veränderungen der Röhrenknochen bei Bronchiektasie. Wiener klinische Wochenschrift, 1889, 2: 226.
- ↑ P. Marie. De l’osteo-arthropathie hypertrophiante pneumique.Rév Med, Paris, 1890, 10: 1-36.